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HealthCommunities of HealthWith all the work to make health care treatment more effective and costs more manageable, health continues to deteriorate in America. As U.S. annual total health care spending exceeds $2 trillion, the time is right to change the national dialogue on health, and to explore the deep causes of illness and disease that drive people into the care system in the first place. Conventional wisdom says that good health is the result of individual behavior, lifestyle, genetics and good medical care. However, evidence is mounting that community forces - such as social conditions, economic opportunity, food and transportation - strongly influence health as well, accounting for at least 50% of morbidity and mortality. While healthy lifestyles and access to quality care will always be important, CIGNA is calling for an integrated approach that simultaneously addresses both individual and social dimensions of health. CIGNA has introduced Communities of Health, an initiative that engages communities in improving social and environmental conditions that fundamentally determine health, well-being and security for individuals and across populations. This initiative is part of CIGNA's Health Strategy & Policy organization, which has developed, tested and refined CIGNA's Communities of Health model for more than two years in collaboration with business, community, academic and governmental leaders. (Read the press release: http://newsroom.cigna.com/article_display.cfm?article_id=997) Currently Communities of Health is operating two pilot projects in Las Vegas, Nevada and Houston, Texas. In addition to the two pilots, ongoing test-and-learn labs are being conducted within employer, small organization, neighborhood and academic contexts. In 2009 Communities of Health will expand into new pilot sites. To explore and address these fundamental determinants of health within a specific community, it is necessary to engage three broad constituencies:
A pre-condition for productive engagement of these constituencies is respect for the expertise of the community itself. We believe that public awareness of social determinants will continue to accelerate, fueled by a surge in community-based coalitions, grass-roots efforts and legislative action. Public policy and advocacy in AmericaWe believe it's time for our industry to broaden its historic focus on fixing health-related problems after they occur to include strong emphasis on prevention and wellness. Providing preventive care and promoting healthy behaviors are investments in the health and economic well-being of any population in any country - including America, where we believe this mindset should be adopted by both the private and public sector. CIGNA supports moving toward a health care system that makes access to care universal - fosters and rewards quality - and makes care more affordable by educating people about the true costs and quality of care and supporting better decision-making. This system would be created through a partnership between the private and public sector, taking the best of what each offers and creating a system that addresses the needs of all. CIGNA is taking a proactive role in contributing to reform discussions. We have been actively working with legislators at both the state and federal levels, as well as with business and industry groups. We believe that the employer should remain the primary source of coverage for working individuals and their families. More than 165 million Americans obtain their health insurance benefits through the workplace. The system certainly can be improved, but it works and we are focused on ways to make it even more effective. CIGNA is very active in AHIP, the trade association for America's Health Insurance Plans, which has declared its support for individual coverage mandates. We believe that all individuals should obtain the coverage that best meets their needs and take responsibility for his or her own health and health care. More information is available at the AHIP website: http://www.americanhealthsolution.org As our country looks at how to make the U.S. health system better, part of the process is to examine how health systems work in other countries around the world. To support that effort, the CIGNA Foundation is providing a grant of $1 million to the Wye River Group on Healthcare (WRGH), http://www.wrgh.org, a neutral, non-partisan group dedicated to constructive health care change. The grant created the Global Knowledge Exchange Network (GKEN), which examines health care practices internationally to discover what works well and why. Supporting the development of the GKEN provides an opportunity for us to contribute to the common good through an initiative that will identify leading health care practices worldwide so we can learn how to improve the health system better here and in other industrialized nations. Quality of careCIGNA has been a strong proponent at the national level for the implementation of national quality standards within the health care industry. CIGNA HealthCare has a long history and record of success in seeking external validation of our quality improvement programs. We have made a substantial investment of resources to achieve accreditation of our health plans by the National Committee for Quality Assurance (NCQA) and to participate in the Healthcare Effectiveness Data and Information Set (HEDIS®) and the Consumer Assessment of Health Providers and Systems (CAHPS®) to measure and report our quality and customer service performance. We are proud of our overall results. NCQA's Quality Compass, summarized in the annual NCQA "State of Health Care Quality" report, is a database of health plan performance that includes information on clinical performance and member satisfaction. For the seventh straight year, CIGNA HealthCare Health Maintenance Organization (HMO)/Point of Service (POS) results exceeded the Quality Compass® national average for the majority of key preventive and chronic care measures. We also continue to compare favorably against our main competitors. According to a CIGNA analysis of the NCQA data, CIGNA's programs have led to a greater than 25 percent (25%) improvement in key indicators of health care quality for individuals in our HMO and point of service plans over the past seven years, including a four percent (4%) improvement from 2007 to 2008, the single biggest year-over-year increase in four years. 2008 also marks the first year that information about quality of care in Preferred Provider (PPO)-type plans is being publicly reported. In 2004, CIGNA became the first national health service company to voluntarily commit to measuring and reporting to NCQA on indicators of health care quality for individuals in our PPO-type plans and has provided this information to NCQA for quality benchmarking purposes since 2006. According to CIGNA's analysis, our programs have led to an eight percent improvement in key indicators of health care quality in our PPO-type plans over the past three years, including a five percent improvement from 2007 to 2008. For this baseline year, CIGNA's scores are on par with, or higher than, the NCQA national average and the average of competitors that reported PPO information this year. For CAHPS results, across many key measures, CIGNA reported scores this year that were on par with, or higher than, the national averages. The opportunity to improve quality is one of the reasons behind CIGNA's push to publicly report our progress and our efforts to help establish a national model for physician performance measurement programs. In 2008, CIGNA was the first to have our physician performance measurement programs reviewed by a "ratings examiner," the NCQA. In early 2008, CIGNA also joined a group of leading consumer, employer, physician and labor organizations in endorsing a national "Patient Charter" that calls for making information about physician performance available to individuals, and independent review of health plan physician performance measurement programs. CIGNA became the first national health care plan - in 2007 - to earn NCQA "Distinction" status across all of our 23 accredited HMO and POS plans for the way the plans measure and provide information about the quality of physician and hospital care. In addition to these efforts, CIGNA has launched new programs that identify ways to improve health sooner, before disease or complications occur, and that aim to improve quality by making it easier for people to get information to help gauge the quality and cost of care from among different providers. Examples include:
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